What is living with psychosis like?

What is psychosis?

Psychosis is a mental health condition that causes people to perceive or interpret things differently from those around them. The two main symptoms are hallucinations and delusions. Hallucinations are seeing, hearing, feeling, tasting or smelling things that don’t exist or are distorted. For example, someone may hear voices or see things that aren’t really there. Delusions are fixed, false beliefs that are firmly held even when there is evidence to the contrary. For example, someone may believe they are being watched or followed when they are not.

Psychosis affects about 3 in 100 people at some point in their lives. It is more common in young adults, but can affect people of any age. The exact causes are unknown, but risk factors include genetics, childhood trauma or abuse, stress, drug use, lack of sleep, etc. Psychosis is a symptom of conditions like schizophrenia, bipolar disorder, severe depression or drug-induced psychosis.

What’s it like to live with psychosis day-to-day?

People with psychosis describe living in two realities – the reality they experience through their symptoms, and the reality others around them live in. Trying to tell the difference between real and unreal experiences can be extremely disorienting.

Here are some examples of what daily life with psychosis might be like:

• Hearing voices that others cannot hear. The voices may be familiar or unfamiliar, friendly or scary. They may comment on the person’s behavior, argue with each other, or command the person to do things.
• Seeing shadows, figures or objects that aren’t really there. For example, seeing threatening figures in the corner of the room or bugs crawling on the walls.
• Feeling touches when nothing is there, like something brushing against the skin.
• Smelling odors such as burning rubber when there is no source.
• Having fixed, false ideas like believing the TV or radio is sending secret messages. No amount of reasoning can change these delusional beliefs.
• Having disorganized thinking and speech that jumps between topics in confusing ways.
• Feeling confused about what is real. For example, being unable to tell if someone is an imposter or an hallucination.
• Experiencing dramatic shifts in mood and energy levels.

In addition to these symptoms, people with psychosis often struggle to perform daily activities like self-care, school/work and relationships. The inability to separate real from unreal makes normal life very challenging.

What are the positive symptoms of psychosis?

Psychosis symptoms are usually divided into positive and negative types:

Positive symptoms refer to experiences that are added or excessive compared to normal. These include:

• Hallucinations – hearing, seeing, smelling or feeling things that are not there. Auditory hallucinations like hearing voices are most common.
• Delusions – fixed, false beliefs like being harmed or harassed by others, or having special powers.
• Disorganized thinking and speech – confused thinking displayed in rambling or nonsense speech.
• Abnormal movements – repetitive or bizarre body movements or postures.
• Catatonic behavior – decreased reactivity to the environment like holding rigid poses for long times.

Positive symptoms often respond well to medications. However, they can still be distressing and scary for the person experiencing them.

What are the negative symptoms of psychosis?

Negative symptoms refer to abilities that are reduced or absent in people with psychosis:

• Lack of motivation – loss of drive, reduced goal-setting.
• Social withdrawal – isolating from family/friends, lack of interest in socializing.
• Impaired speech – reduced talking and conversing.
• Flattened emotions – decreased emotional expression, like less smiling or excitability.
• Inability to feel pleasure – reduced enjoyment from fun activities.
• Poor attention and focus – trouble concentrating or paying attention.

Negative symptoms greatly affect daily functioning in social, occupational and educational domains. They tend to respond less well to medications and therapy is often needed.

How does psychosis typically develop over time?

Psychosis develops gradually in three main phases:

1. Prodromal phase – subtle behavioral and perception changes emerge. Person may feel anxious or depressed and withdraw socially. Sleep and concentration problems occur. These mild symptoms can progress slowly over months or years.
2. Acute phase – positive symptoms clearly manifest. This dramatic worsening of symptoms often prompts help-seeking. Hallucinations, delusions, disorganized speech and behavior make functioning very difficult.
3. Residual phase – positive symptoms improve with treatment but negative symptoms persist. Many people have residual impairments in cognition, emotions and relationships.

The course of psychotic disorders varies – some people recover fully while others have lifelong disabilities. With treatment, most people can manage symptoms well enough to maintain relationships and productive lives.

What are common treatments for psychosis?

Treatment focuses on:

1. Reducing symptoms, especially positive symptoms which respond best to treatment.
2. Improving functioning in work/school, self-care, socializing, etc.
3. Preventing relapses.

The main treatments are:

Medications – Antipsychotics are the primary medications prescribed. They help reduce positive symptoms like hallucinations and delusions. Other medications can augment treatment, like antidepressants or anti-anxiety drugs.

Psychosocial therapies – Cognitive behavioral therapy helps people identify and respond to early warning signs of relapse. Social skills training improves communication and relationship abilities. Supported education/employment helps people achieve school and work goals.

Self-management strategies – Stress management, routine management, journaling and peer support all help people manage their illness effectively.

Treatment is tailored to each person’s symptoms, life circumstances and preferences. Most people use medications combined with psychological and self-help approaches.

What is recovery like for people with psychosis?

Recovery is defined as regaining functioning, pursuing meaningful life activities, and having autonomy over one’s life. It is a journey unique to each person.

For many people, recovery from psychosis involves:

• Finding the most helpful treatment to control symptoms.
• Developing skills to manage stress, mood, relationships, etc.
• Setting personal goals related to work, school, hobbies, health, etc.
• Building social connections for friendships, peer support and stigma reduction.
• Finding purpose and meaning in life despite limitations from illness.
• Gaining self-confidence to make decisions and self-advocate.
• Accepting that recovery is an ongoing process with ups and downs.

With the right supports, the majority of people with psychosis can lead productive, meaningful lives. However, recovery does not necessarily mean being symptom-free. Many people continue experiencing some symptoms episodically through their lives. With effective coping strategies, symptoms can be managed successfully.

What are the most difficult parts of living with psychosis?

People with psychosis describe many challenging aspects of the illness:

• Fear and confusion from experiencing symptoms: Hallucinations and delusions can be terrifying since they seem completely real. People often worry the symptoms mean they are “going crazy.”
• Stigma: Negative stereotypes like being “dangerous” or “unpredictable” lead to social isolation and low self-esteem.
• Medication side effects: Antipsychotics often cause distressing effects like weight gain, restless movements, lethargy, etc.
• Uncertainty: Not knowing when symptoms will recur causes constant stress. Many people fear being unable to work or live independently if their illness worsens.
• Cognitive problems: Difficulties with memory, concentration and planning hinder daily tasks and socializing.
• Loneliness: Loss of friends and strained family relationships because of prolonged illness are common.
• Loss of opportunities: Goals for work, relationships and independence are curtailed by long-term disability.

Despite these challenges, many people find new meaning and purpose through connecting with others, helping educate society, and advocating for themselves and others affected by mental illness.

What are misconceptions people have about psychosis?

Some common misconceptions about psychosis include:

• People with psychosis are violent or dangerous – In fact, people with mental illness are more likely to be victims than perpetrators of violence.
• Psychosis is untreatable – Treatment can reduce symptoms and improve quality of life for most people.
• People can’t recover from psychosis – Recovery is very possible but looks different for everyone.
• Medications are the only treatment option – Therapy, social support, education and self-care are also critical.
• Psychosis is a life-long unchanging condition – Many people have episodic symptoms and clear improvements over time.
• People with psychosis are completely unable to function – With treatment, most can manage demands of work, school and relationships.
• Psychosis is a single diagnosis or personality type – It is a set of symptoms with many contributing factors.

These mistaken beliefs perpetuate stigma. They prevent people from seeking help early and undermine recovery. Accurate information about psychosis and mental illness is essential to break down stigma.

What are warning signs and risk factors for psychosis?

Some early warning signs of possible psychosis include:

• Social withdrawal and isolation
• Decline in self-care and hygiene
• Trouble concentrating or following conversations
• Suspiciousness or extreme unease around others
• Decline in academic or work performance
• Spending a lot more time alone in own thoughts
• Increased sensitivity to sights/sounds/smells
• Mood changes like depression or mania
• odd speech or behavior

Risk factors for developing psychosis include:

• Family history of psychosis
• Drug or alcohol abuse, especially marijuana
• Major stress or trauma
• Physical illness or brain injury
• Being disconnected from family/friends
• History of depression or bipolar disorder
• Poverty, abuse, discrimination

If noticed early, warning signs present opportunities for intervention and prevention of worsening illness. People can seek help from counselors, peer support groups, or early psychosis programs.

Conclusion

Living with psychosis is an extremely challenging mental health condition. It distorts perceptions of reality, making normal life difficult. People often struggle greatly when acute symptoms first emerge. With the right treatment and supports, most people can manage their illness successfully over time. Recovery involves more than just symptom control – it means pursuing meaningful life activities and relationships.

There are still many misconceptions that perpetuate stigma against mental illness. Accurate information and compassionate listening are essential to support people affected by psychosis. While incredibly difficult, living successfully with psychosis is absolutely possible.